微生物检验在肺曲霉菌感染患者临床诊治中的应用价值

Application value of microbiological test in the clinical diagnosis and treatment of pulmonary Aspergillus infection

目的分析微生物检验在肺曲霉菌感染临床诊断及治疗中的应用价值。方法回顾性选择2017年8月至2019年9月接收的75例肺曲霉菌感染患者为研究对象,采用GM试验、G试验及痰培养三种方法予以微生物检验,比较三种检测方法及联合检验对肺曲霉菌的阳性检出率。同时,比较寄生型和侵袭型肺曲霉菌感染患者的临床表现、治疗方法及预后。结果GM试验对寄生型、侵袭型肺曲霉菌的阳性检出率均高于G试验和痰培养(P<0.05);三项联合检验对寄生型肺曲霉菌的阳性检出率均高于三项单独检验(P<0.05);三项联合检验对侵袭型肺曲霉菌的阳性检出率均高于G试验和痰培养单独检验(P<0.05)。寄生型肺曲霉菌感染患者咯血发生率高于侵袭型肺曲霉菌感染患者,发热、咳嗽、胸闷及肺啰音发生率均低于侵袭型肺曲霉菌感染患者(P<0.05)。寄生型肺曲霉菌感染患者以手术治疗为主,药物治疗为辅,治愈率为94.00%;侵袭型肺曲霉菌感染患者以药物治疗为主,治愈率为92.00%。结论微生物检验方法的联合应用可有效提高肺曲霉菌感染的诊断率,并为寄生型和侵袭型肺曲霉菌感染患者的治疗方法及预后评估提供参考依据。

Objective To analyze the application value of microbiological test in the clinical diagnosis and treatment of pulmonary Aspergillus infection.Methods Seventy-five cases of pulmonary Aspergillus infection patients enrolled from August 2017 to September 2019 were retrospectively selected as the research objects.GM test,G test and sputum culture were used for microbiological examination.The positive detection rate of pulmonary Aspergillosis by three detection methods and combined detection were compared.At the same time,the clinical manifestations,treatment methods and prognosis of patients with parasitic and invasive subtypes of pulmonary Aspergillosis infection were compared.Results The positive detection rates of GM test for parasitic and invasive subtypes of pulmonary Aspergillosis infection were higher than those of G test and sputum culture(P<0.05);the detection positive rate of three combined tests for parasitic subtype of pulmonary Aspergillosis infection was higher than that of three separate tests(P<0.05);the detection positive rate of three combined tests for invasive subtype of pulmonary Aspergillosis infection was higher than that of G test and sputum culture test(P<0.05).The incidence of hemoptysis of patients with parasitic pulmonary Aspergillus infection was higher than that of patients with invasive pulmonary Aspergillus infection,and the incidences of fever,cough,chest distress and lung rale were lower than those of patients with invasive pulmonary Aspergillus infection(P<0.05).Surgical treatment was the main treatment method for parasitic pulmonary Aspergillosis patients,supplemented by drug treatment,with a cure rate of 94.00%,while drug treatment was the main treatment method for invasive pulmonary Aspergillosis patients,with a cure rate of 92.00%.Conclusion The diagnosis rate of pulmonary Aspergillus infection can be effectively improved by the combination of microbiological test methods.On this basis,it can provide reference for the treatment methods and prognosis evaluation of patients with parasitic and invasive pulmonary Aspergillus infection.